Placement Application:

This questionnaire is intended to be a guide to help you think about all the ways a pet will impact your life and also determine if a pet is the right breed for you. All of the questions concern various aspects of dog ownership that should be given serious consideration before deciding to share your life with any dog. It is by no means meant to be a test which will be used to disqualify you from consideration for a pet. Please make sure you understand the application process prior to filling out this form. If you need to review it, Click Here.

Me and my Family

I am applying to:   Adopt
Foster
Help with rescue

How were you referred to us?

Name:


E-mail:



Address:

City:    State:    Zip:
Please Note: We must know your state to process the application.
Phone #:


Work#:
Age:

Marital Status:

 
Occupation:



Number in Household?
Children?
If Yes, what age?

Preferences

Please check any preferences on Age and Sex. Please note: The average age of a rescue is between 3 - 6 years of age and all rescues will be spayed/neutered before adoption. If you prefer a younger pet, your wait may be slightly longer. We rarely have puppies.


Age:

Sex:
Are you willing to accept a dog with special medical needs?

Are you willing to accept a dog with a history of neglect/abuse who needs extra love and attention?


Are you willing to accept a dog with behavior problems who requires special training?



Why A Rescue Dog?
Have you previously owned a dog?



Which dog/dogs are you interested in?

Why are you considering this dog/dogs or breed?


Please describe what you feel are the characteristics of the ideal pet for you and your family.



Your Home
Which of the these best describes your current residence?

Does your lease or home owners assoc. restrict pet ownership?

Does your town or city have restrictions on the number of dogs you can have?

Is your yard, or a portion of your yard, securely fenced?

If you have a pool, is it fenced?

If you have a dog run, is it secure?


References
Please provide three names as references, including your veterinarian, and your landlord (if you rent your home). Other references could include a neighbor, your employer, a friend or relative who owns a pet, other toy breed or other high maintenance breed (such as poodle or Afghan Hound).
Name, Phone number and relationship to applicant:

Care and Responsibility
The pet is a high maintenance dog, and while you may love the breed you may discover that you do not have the time or the resources to devote to its upkeep. But if you do, the pet will more than repay you with a lifetime of loyalty.

Are you prepared to pay someone up to $40, or more, every 4 weeks to groom your pet? Or are you prepared to purchase a grooming table, clippers, scissors and other accessories and devote the time to learn to groom your pet yourself?

Are you willing to spend approximately one hour each week brushing and combing out your pet? This additional maintenance is required whether the dog is being professionally groomed or you are grooming your dog yourself. Are you willing to pluck the hair from the inside of the ears monthly to prevent infections and to clean the eyes of accumulated matter daily if necessary? Are you prepared to deal with the cost of both routine veterinarian care (worming, annual shots) and non-routine/emergency veterinary care, especially as the dog gets older?



Approximately how many hours a day will your new pet be alone?

Where will your pet spend the day?

How much time will you have to spend with your pet?

Where will your pet sleep at night?

Who will have primary responsibility for the care of your pet?


History of Pet Ownership
What animals currently live in the household? (Please list type of animal, sex, age and how long you have owned them)
Are they kept inside or outside?
Please list any dog you have owned in the past and explain what happened to it.
Of the dogs that you own or have owned, what do you enjoy most about dog ownership?
What do you like least about dog ownership?

In the case of Fostering, the person(s) agreeing to foster an animal (the Foster Family) will follow all relevant procedures and guidelines regarding the animal as stated in the Shih Tzus & Furbabies Contract. If the animal cannot be kept by the Foster Family, the Foster Family shall notify a Rescue Coordinator immediately. The animal shall not be sold, abandoned, relinquished to a pound or shelter or to a Rescue group other than Shih Tzus & Furbabies, transferred, or given to any individual, or to any retail or wholesale establishment.


All of the information I have provided is true and complete to the best of my knowledge. Should a pet be placed with me it will reside in my home as a pet. I agree to provide the dog with adequate food, water, shelter, affection and medical care.
Signature of Applicant:
Date of Application:
How would you like us to contact you? Send E-mail
Send surface mail
Please call
Any other comments?


Thank you for taking the time to complete this questionnaire. Your answers will permit us to more effectively match available dogs' needs with your lifestyle and requirements.

Our E-mail address:info@shihtzusandfurbabies.com

   

Please hit the send button only once.
You will be taken to a confirmation page when send process is completed.